Hospitalisations liées à la santé mentale chez les adolescents et les jeunes adultes émergents autistes aux États-Unis : analyse rétrospective et transversale des données nationales de sortie d'hôpital

Titre original en anglais : Mental health–related hospitalizations among adolescents and emerging adults with autism in the United States: A retrospective, cross-sectional analysis of national hospital discharge data

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». La publication indique que des personnes autistes en sont auteur·ices ou co-auteur·ices, sans préciser leur nombre ni divulguer leur identité.

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McMaughan, D. J., Imanpour, S., Mulcahy, A., Jones, J., & Criss, M. M. (2023). Mental health–related hospitalizations among adolescents and emerging adults with autism in the United States: A retrospective, cross-sectional analysis of national hospital discharge data. Autism, 27(6), 1702-1715. https://doi.org/10.1177/13623613221143592

Date de publication: 04/01/2023 Ajout dans AutiHub: 21/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
5
Auteur·ices autistes mentionné·es dans la publication
Nombre non précisé
  1. Darcy Jones (DJ) McMaughan
  2. Sara Imanpour
  3. Abigail Mulcahy
  4. Jennifer Jones
  5. Michael M Criss

Résumé

Les adolescents et les jeunes adultes émergents autistes présentent des taux élevés de troubles de santé mentale, un facteur de risque d'hospitalisation. À l'aide de données représentatives à l'échelle nationale issues du HCUP KID de 2016, nous avons estimé la prévalence et les coûts des hospitalisations liées à la santé mentale chez les adolescents et les jeunes adultes émergents autistes aux États-Unis. Les sorties d'hôpital pour les personnes âgées de 10 à 20 ans (n = 1,346,849) ont été analysées au moyen d'une régression logistique ajustée pour le plan d'enquête et d'une modélisation linéaire générale. Les hospitalisations liées à la santé mentale chez les jeunes autistes (n = 14,368) concernaient principalement des troubles neurodéveloppementaux, perturbateurs, dépressifs et bipolaires. Les hospitalisations liées à la santé mentale étaient près de 11 fois plus probables (OR = 10.98, IC à 95 % = 10.00–12.00) chez les jeunes autistes que chez les jeunes présentant des affections complexes et chroniques, et deux fois plus probables (OR = 2.03, IC à 95 % = 1.88–2.19) que chez les témoins issus de la population. Les coûts moyens prédits de prestation de services pour les hospitalisations liées à la santé mentale chez les adolescents et les jeunes adultes émergents autistes étaient de 7,401.23 dollars américains par séjour, ce qui correspond à un coût total estimé de prestation de services de 106 millions de dollars américains en 2016. Les hospitalisations liées à la santé mentale peuvent indiquer des soins de mauvaise qualité, être traumatisantes et augmenter le risque de suicide. Des soins communautaires de santé mentale destinés aux jeunes autistes sont nécessaires. Résumé grand public Les jeunes autistes sont plus susceptibles de présenter des troubles de santé mentale, tels que la dépression et le trouble bipolaire, que les personnes non autistes. Ces problèmes de santé mentale conduisent parfois à des hospitalisations, qui peuvent être coûteuses et traumatisantes. Pour cette raison, nous voulions comprendre les hospitalisations liées à la santé mentale chez les jeunes autistes âgés de 10 à 20 ans. Nous avons constaté que les principales raisons de santé mentale des hospitalisations chez les jeunes autistes étaient des troubles neurodéveloppementaux, perturbateurs, dépressifs et bipolaires. Ces hospitalisations coûtaient en moyenne 7,401.23 dollars américains par séjour, pour un total de 106 millions de dollars américains en coûts de prestation de services en 2016. Les hospitalisations liées à la santé mentale ont été comparées entre les jeunes autistes, les jeunes présentant des affections complexes et chroniques, et les jeunes ne présentant aucune affection chronique. Les jeunes autistes étaient près de 11 fois plus susceptibles d'être hospitalisés pour des raisons de santé mentale que les jeunes présentant des affections complexes et chroniques, et deux fois plus susceptibles que les jeunes ne présentant pas d'affections complexes et chroniques. Nous estimons que les États-Unis ont besoin de meilleurs soins communautaires de santé mentale pour les jeunes autistes.

Autistic adolescents and emerging adults experience high rates of mental health conditions—a risk factor for hospitalization. Using nationally representative data from the 2016 HCUP KID, we estimated the prevalence and costs of mental health–related hospitalizations for autistic adolescents and emerging adults in the United States. Hospital discharges for ages 10–20 years (n = 1,346,849) were analyzed using survey-adjusted logistic regression and general linear modeling. Mental health–related hospitalizations among autistic young people (n = 14,368) were mostly for neurodevelopmental, disruptive, depressive, and bipolar disorders. Mental health–related hospitalizations were almost 11 times more likely (OR = 10.98, 95% CI = 10.00–12.00) for autistic youth compared youth with complex and chronic conditions, and two times (OR = 2.03, 95% CI = 1.88–2.19) more likely compared to population controls. Predicted mean service delivery costs of mental health–related hospitalizations for autistic adolescents and emerging adults were US$7,401.23 per stay, resulting in US$106 million in estimated total service delivery costs in 2016. Mental health–related hospitalizations can indicate poor quality care, be traumatic, and increase suicide risk. Community mental health care for autistic young people is needed. Lay abstract Autistic young people are more likely to have mental health conditions, like depression and bipolar disorder, than people without autism. These mental health issues sometimes lead to hospitalizations, which can be expensive and traumatic. Because of this, we wanted to understand mental health–related hospitalizations among autistic young people aged 10–20. We found that the main mental health reasons for the hospitalization of autistic young people were neurodevelopmental, disruptive, depressive, and bipolar disorders. These hospitalizations cost an average of US$7401.23 per stay, for a total of US$106 million in service delivery costs in 2016. Mental health–related hospitalizations were compared between young people with autism, young people with complex and chronic conditions, and young people with no chronic conditions. Autistic young people were almost 11 times more likely to be hospitalized for mental health reasons than young people with complex and chronic conditions, and two times more likely than young people with no complex and chronic conditions. We believe the United States needs better community-based mental health care for young people with autism.

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Références citées
76
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64
Sans DOI, à partir du texte brut de la bibliographie
10
4 / 76 (5,3 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
8 / 76 (10,5 %)
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68 / 76 (89,5 %)
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8
Sans titre structuré
8
Sans identifiant stable
10
Références avec noms bruts d’auteurices restant à vérifier
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Noms d’auteurices détectés dans la bibliographie citée
373
À partir du DOI ou de métadonnées externes
373
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
13
82 / 373 (22,0 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 291 / 373 (78,0 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
14 / 373 (3,8 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 14 / 82 (17,1 %). Personnes distinctes identifiées comme autistes : 13 / 337 (3,9 %).
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